Revenue Management Coding Specialist

Overview

Salary: 22.5-33.75/hour

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

Premium pay such as shift, on call, and more based on a teammate's job

Incentive pay for select positions

Opportunity for annual increases based on performance

Benefits and more

Paid Time Off programs

Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

Flexible Spending Accounts for eligible health care and dependent care expenses

Family benefits such as adoption assistance and paid parental leave

Defined contribution retirement plans with employer match and other financial wellness programs

Educational Assistance Program

Job Summary

Perform charge capture reviews in accordance with proper organization practices. Collaborates with internal departments on charging and coding functions to determine accuracy and optimize revenue capture. Maintains documentation of review findings and recommendations.

Essential Functions

• Reviews and studies all information from third-party payors on claims filing, coding, and the adjudication process.
• Studies, reports, and makes recommendations regarding compliance concerns.
• Works with coding personnel to ensure that codes on the CDM are accurate and current.
• Analyzes revenue and reimbursement data to maximize financial improvement opportunities.
• Serves as a resource for department managers, staff, and administration to obtain information on guidelines and regulatory standards of coding and billing
• Documents and/or reviews all data collected during the review, identifying all billing, coding and documentation errors
• Reviews clinical documentation to ensure accurate CPT/HCPCS code assignment and appropriate reimbursement
• Assist with education of clinicians on appropriate and compliant charging protocols
• Prepares management reports, spreadsheets and summaries of review findings

Physical Requirements

May Lift and move reports and notebooks weighing up to ten pounds. Ability to work under pressure to meet deadlines. Majority of day is spent sitting.

Education, Experience and Certifications

High School Diploma or GED required. CPC or CCS certification and at least 4 years ICD-9 and CPT coding experience preferred. Experience with or exposure to Epic/Encompass billing system (chargemaster specific) and Epic CDM Certification preferred.